Should national guidelines continue to recommend fetal scalp blood sampling during labor?

Abstract

Intrapartum fetal scalp blood sampling (FBS) (pH or lactate) has not been shown to reduce emergency cesarean sections or operative vaginal births or improve long-term perinatal outcomes. In contrast, it is associated with rare but potentially very serious complications such as leakage of cerebro-spinal fluid (CSF) and perinatal hemorrhagic shock. Therefore, it does not fulfill the “First Do No Harm” principle and its use during labor should be critically re-evaluated.

Keywords:

• Cesarean section
• cerebrospinal fluid
• neonatal outcome
• scalp hemorrhage

Declaration of interest

The author reports that he has no conflicts of interest to declare.

E. C. conducts several Master classes on CTG and fetal ECG in the UK, Europe, Asia. and Australia and is the co-organizer of the Intrapartum Fetal Surveillance Course at the Royal College of Obstetricians and Gynecologists (RCOG) and Fetal Monitoring Courses at St George’s University of London. He uses fetal ECG for intrapartum fetal heart rate monitoring and is a member of the Editorial Board for NHS e-learning on CTG and a Course lead for the Baby Lifeline CTG Masterclasses. He was one of the 3-member guideline development group which revised the international FIGO Guidelines on CTG in 2015.